Costly cancer meds put NHS in quandary

The hand-wringing over costly cancer medicines in the U.K. is something of an object lesson, raising questions about medical care for the haves versus the have-nots, and about just how much money a few more months of life might be worth.

You see, the National Health Service has long had a policy that patients who fork over their own money for expensive meds that aren't reimbursed by the government automatically become private-pay customers who have to pay the whole bill. But after years of complaint from patients--and intense lobbying by advocacy groups--the health minister is reviewing that policy. It's an ethical snarl for the NHS, whose stated mission is equal access to care for all. If the NHS gives the go-ahead for "top-up" payments, that could be a windfall for drugmakers.

Meanwhile, as we all know, the cost of healthcare is rising, and it's not only the NHS that's scrutinizing every expenditure for cost-effectiveness. There's been talk in the U.S., for instance, of some sort of comparative effectiveness research that could in turn limit use of certain meds that may work wonders in some but have little effect on the rest (unless they can be targeted with genetic screening, but that's another story).

With so many drugmakers pinning their financial hopes on a new generation of costly cancer therapies, the debate is destined to drag on.